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Abstract [Objective]To evaluate the efficacy and safety of alfacalcidol[1a-(OH)-D3 ]capsule pulse ther-apy combined with hemoperfusion(HP)for the treatment of continuous ambulatory peritoneal dialysis(CAPD) patients with severe secondary hyperparathyroidism(SHPT).[Methods]Totally 37 CAPD patients with severe SHPT were collected and randomly divided into alfacalcidol pulse therapy combined with HP treatment group (group A,n=19)and alfacalcidol pulse therapy group(group B,n=18).The drug initial dose of two groups was 2~4μg twice a week.Group A simultaneously received HP treatment once a week for 3 weeks.All pa-tients were followed up for 6 months.Immunoreactive parathyroid hormone(iPTH)level,clinical symptoms and cardiac valve calcification before and after treatment were compared.[Results]After treatment,the stand-ard reaching rate of iPTH and symptomatic relief rate in combination group were obviously higher than those in single pulse therapy group,and there was significant difference(P<0.05).After 6 month of follow up,car-diac valve calcification rate in group A was lower than that in group B(73.6% vs.83.3%,P<0.05),while the standard reaching rate of iPTH in group A was higher than that in group B(94.7% vs.77.8%,P <0.05).In group A,the tolerance was good and none had severe side reaction.In group B,3 patients discon-tinued alfacalcidol therapy due to hypercalcemia and hyperphosphatemia.[Conclusion]Alfacalcidol pulse ther-apy combined with HP for the treatment of CAPD patients with severe SHPT has better efficacy and tolerance than single alfacalcidol pulse therapy.
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2014, Vol. 31 
